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Twyford Mark,Westby Daniel,Keohane Colum,Tawfick Wael,Walsh Stewart R 대한창상학회 2023 Journal of Wound Management and Research Vol.19 No.3
Background: Intermittent pneumatic compression (IPC) devices apply intermittent compression to the thigh, which is thought to facilitate wound healing by improving wound perfusion in patients with chronic limb-threatening ischemia and no option for revascularization. Wound Express is an IPC device but its safety and efficacy are currently unclear. In this study, we aimed to determine the safety of the Wound Express IPC system in this high-risk cohort.Methods: This was a prospective, non-controlled, non-randomized pilot safety study. In total, 19 patients were screened for inclusion and 10 were recruited. IPC was applied for 2 hours per day for 12 weeks. The primary endpoint was any treatment-related adverse event in the first 3 months. Secondary endpoints included pain using the visual analogue scale, limb status assessed using the Wound, Ischemia, Foot Infection (WIFi) score and quality of life using the Vascular Quality of Life Questionnaire (VASUQOL) score.Results: Of the 10 patients who were enrolled, eight completed the 12-week course. There were no treatment-related adverse events. One patient died from coronavirus disease 19-related disease and two withdrew for reasons unrelated to treatment. Median pain scores were reduced from 6 to 0, while median VASUQOL increased from 10 to 16.5. WIFi scores were reduced in three out of eight of participants (37.5%).Conclusion: Wound Express appears to be safe and may decrease pain, improve wound healing and improve quality of life for chronic limb-threatening ischemia patients. Adequately powered, prospectively randomized trials of the Wound Express system to assess its efficacy and safety are warranted.
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Outcomes of Unibody Bifurcated Endograft and Aortobifemoral Bypass for Aortoiliac Occlusive Disease
Baker Ghoneim,Mohamed Elsherif,Mohamed Elsharkawi,Yogesh Acharya,Niamh Hynes,Wael Tawfick,Sherif Sultan 대한혈관외과학회 2020 Vascular Specialist International Vol.36 No.4
Purpose: We compared the outcomes between the total endovascular approach usinga unibody bifurcated aortoiliac endograft and the gold standard aortobifemoralbypass (ABF) surgery for the management of extensive aortoiliac occlusive disease(AIOD). Materials and Methods: This retrospective observational study compared the outcomesof endovascular technique with unibody bifurcated endograft (UBE) usingthe Endologix AFX unibody stent-graft and a standard surgical approach (ABF) inthe management of AIOD based on patient records in Western Vascular Institute,Galway University Hospital, National University of Ireland. Procedural details andoutcomes were documented to compare both groups. Results: From January 2002 to December 2018, 67 patients underwent AIOD (20UBE and 47 ABF). Both the ABF and UBE groups showed 100% immediate clinicaland technical successes without 30-day mortality. There were no statisticaldifferences in the overall survival and sustained clinical improvement betweenthe bypass and the UBE groups; however, statistically significant differences wereobserved in 3-year freedom from re-intervention and amputation-free survival. Furthermore, the mean length of the intensive care unit (ICU) stay was significantlylower in the UBE group than that in the ABF group (0.75 days vs. 3.1 days,P=0.001). Conclusion: Total endovascular reconstruction of AIOD is an alternative to invasivebypass procedures, with a shorter ICU stay.
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